Rethinking Thin

I recently read Rethinking Thin: The New Science of Weight Loss — and Realities of Dieting by Gina Kolata who is a science writer for the New York Times.  I’ve read one of her earlier books, Ultimate Fitness, and knew she could take the dry facts and make them an interesting and compelling read.

In Rethinking Thin Kolata interleaves the chapters covering the history of weight loss and obesity research with interviews with four research subjects in a study comparing the merits of the Atkins diet with the LEARN (low fat) diet.  Much of the information in the book I’d read elsewhere, but it seeing pulled together in one place was eye-opening.  Some of what she reports:

  • Over time, the weight  for an ideal body has fallen lower and lower, putting more and more pressure on people to diet.
  • No diet has been proven more effective at producing weight loss than any other.  (I have read elsewhere, however, that the Mediterranean Diet produces better blood lipid levels.)
  • Research done by Albert J. Stunkard of the University of Pennsylvania shows that there is no significant difference in the way obese people eat and the way thin people eat.
  • A study conducted in Europe in 1986 showed that adopted children are of the same fatness as their biological parents.
  • The conclusion of a twin study in 1990 by Stunkard was that 70% of the variation of a population’s weight was due to inheritance.
  • Short term studies on weight loss can be misleading, because the body’s homeostasis works over the long term to return to balance.
  • According to endocrinologist Jeffrey S. Flier, “. . . weight regulation in humans is at the interface of free will and determinism.  There is a strong biological underpinning to our drive to eat and maintain certain weights. . . .  there is another layer of mechanisms by which things like hormones not only can affect the neurochemistry that affects how hungry you are, but also can affect the wiring of your brain.”
  • Decades of research show that very few people lose substantial amounts of weight and keep it off.  We probably have a set point range of 20 – 30 lbs.   The best a dieter may expect to do is to maintain a loss of 10% to 15% of their body weight with constant vigilance.
  • Obesity is not as dangerous as is commonly assumed.  Studies casting doubt on the dangers of obesity have been ignored and attacked by the obesity “establishment” while simultaneously being praised by statisticians.

One deficiency of the book was a lack of information about research on that small percentage of people who do lose weight and keep it off.  Kolata quoted James O. Hill of the University of Colorado only in the context of his opposition to the research done by Katherine Flegal and her team that showed that overweight (not obese) people have a lower mortality rate than people of so-called normal weight.  Hill is one of the founders of The National Weight Control Registry, a research organization that studies people who have lost at least 30 lbs. and kept it off for at least a year.  (The average weight loss of their registrants is about 60 lbs. and they’ve kept it off for an average of 5.5 years.)

Kolata also is dismissive of the ideas that eating more often at  restaurants (which serve overly large meals),or our increased intake of fast food and processed food, has any significant impact on our increased incidence of obesity in the population as a whole.

I would also like to have seen more discussion of the relation of physical activity to weight loss.

What is interesting to me, beyond the data, is my reaction to this information.  I feel both relieved that my body has been largely responsible for my weight through genetics and neurochemistry.  I haven’t felt a desire to get really skinny for years, but now that I know that’s unrealistic, it’s off the table (no pun intended).  With the exception of when I was really sick a couple years ago, my weight has been stable (within a 5 lb. range) for the last 20 years. On the other hand, I really hate “giving up.”  It’s surprisingly difficult to accept that my body is happy right where it’s at, and will stubbornly protect itself from what it perceives as famine.


BTW, I’d like to recommend Heroic Stories to you.  Subscribe to it, and every so often a story contributed by a reader will show up in your e-mailbox that will restore your faith in your fellow man.


Filed under Book reviews

8 responses to “Rethinking Thin

  1. Benita

    As the Shadows would say “What do you want?”
    The twin studies indicate that 70% of wt is genetic. That leaves 30% that isn’t. What kind of sacrifices are you willing to make to change that 30%?
    And like the Shadows, the cost may be much higher than you expect….
    That small percentage that lose weight and keep it off contain a portion of what I call “walking wounded”…They don’t meet the DSM criteria for an Eating Disorder because 1. They never present for treatment and 2. Their obsession is on keeping their weight in a narrow range, not continual loss and 3. When they “silp” they have the skills to get back to that narrow range and 4. The behvaiors they use to stay in that range are mostly PHYSICALLY healthy….PSYCHOLOGICALLY healthy is another thing entirely.

    • And even whether the behaviors used to keep weight within a certain range is physically healthy is open to question. According to the website of the National Weight Control Registry, those who successfully maintain a loss of (on average) 30 lbs or more are exercising a minimum of 60 minutes a day and consuming 1360 kcal a day. That’s a pretty restrictive diet.

      As for the question of what kind of sacrifice are you willing to make to change that 30%, that’s a topic for another blog. 🙂

  2. I sometimes feel like much of our society has a low grade eating disorder, given how much energy gets put into obsessing over food and weight, to the point where it takes energy from other things. The number of women I know who literally CANNOT enjoy a meal because there’s so much guilt attached to the very act of eating is huge. It worries me.

    More disturbing still is how conscious a choice it takes to not obsess 24/7 over body weight oneself, given how much societal pressure there is around this. It’s as if as women have this weird tunnel vision, and feel like nothing else matters unless our bodies meet some standard of perfection first. I’ve heard women literally talk about how they need to lose weight “in order to start living,” as if they need a perfect body to have permission to enjoy life at all.

    That’s far less healthy than being overweight, IMHO.

  3. Weight is such a fraught subject, because so many of us suffer from the awareness that we don’t match the ideal held up by our media and culture. It’s difficult to maintain a healthy relationship with our bodies and our psyches in the current cultural climate of “thin is beautiful” (which has been with us for many decades and, as you pointed out, relies on an increasingly thinner ideal) in combination with the easy access to food. Unfortunately,the psychological issues are greater than the internalization of thin as a norm. Any child who’s ever been made fun of on the playground because of their weight, anyone (man or woman) who’s ever tried to date, anyone who’s ever been told by a spouse or loved one that they should lose weight or are fat, knows that being “overweight” in our society can have devastating effects; it can even be a factor in job hunting. I hope the many books and articles about the ways in which our society’s obsession with weight are harmful, coupled with the negative attention recently given to a number of celebrities who suffer from anorexia, indicate that our society will start moving in a healthier direction.

    While I appreciate much of what you mention, it bothers me that Kolata is dismissive of the idea that large servings in restaurants, fast food, and processed foods are a significant part of the equation; that both seems counter-intuitive to me and contradicts some recent studies about how much more easily our bodies can use the calories in processed foods. Additionally, the genetic equation is extremely complicated; epigenetics looks at ways in which the actions, lifestyles, exposure to chemicals, etc. effect subsequent generations, even in the absence of genetic change, providing evidence that your grandparents’ eating habits may have an impact on your weight. It makes sense to me that if your genetic/epigenetic inheritance is such that you are predisposed to being heavier than that of someone else, and if, “there is no significant difference in the way obese people eat and the way thin people eat,” that it is likely that those predisposed to weight gain are more efficient at metabolizing the food they eat; although, it also seems possible that some of the difference is due to other factors, such as activity levels. Not only does exercise affect weight, but I understand that getting enough sleep actually helps prevent weight gain, while stress can lead to the opposite effect.

    • Indeed, in Healthy at Every Size, Bacon discusses the fact that too little sleep and too much stress can increase cortisol levels which can lead to weight gain. One of my goals (which I am not doing well at) is to get us to bed earlier. That would help us be more rested and reduce my fatigue eating.

      As for our national values, I’m afraid I don’t hold out much hope of them shifting away from thin any time soon. Different segments of our population still regard a more voluptuous figure as attractive, but the ideal ratio of hip to waist still applies no matter the size. Apparently it’s hard wired into the male brain as a signal of fertility. Not surprising since when women enter menopause their hormones shift and they start putting weight on in their belly rather than their hips.

      • Sadly, some women are genetically programmed to gain weight in the belly, more than the hips, well before menopause. This is my genetic heritage, based on the fact that my mother and I both did/do so. By the time I was 13, I had a bulgy tummy, and even when I’d lost weight through diet and exercise, and had a body otherwise fit the “ideal” profile (i.e., too thin!), I still had some roundness there.

  4. If what body type men were drawn to in women were hardwired, though, then we wouldn’t have so much variation in what’s attractive both through time (rubenesques, anyone?) and across cultures (in parts of Africa, being told you’re fat is considered a compliment, and the ideal is far heavier than in the United States).

    (Neverminding the creepiness of women gearing what they find attractive to what men want, which is harmful on so many levels it would take a separate post! But there’s really no one What Men Want anyway.)

    • What I read (too long ago to remember where) was that despite the variance of sizes, the ratio of waist to hip remains approximately the same for what is considered optimal. Whether it’s true or not (statistically speaking) is another matter. Both of the books I reviewed pointed out that one should be skeptical of where information comes from, since funding sources can skew the way research results are reported.

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